How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $676.08 Median $3,235.94 Typical High $4,168.69 | Facility | None | $676.08 | $3,235.94 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,168.69 | Professional | None | $3,715.35 | $3,715.35 | $4,168.69 |
BCBS Louisiana Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,584.89 | Facility | None | $524.81 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,137.96 | $3,162.28 |
United Setting Facility Modifier None Typical Low $354.81 Median $724.44 Typical High $4,073.80 | Facility | None | $354.81 | $724.44 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,137.96 | $3,388.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,862.09 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,819.70 | $1,862.09 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $758.58 Typical High $831.76 | Professional | 53 · Discontinued | $741.31 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,818.38 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,754.23 | $2,818.38 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $630.96 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,630.27 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,630.27 | $2,951.21 |
Where Louisiana sits
The same service costs 18.2 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Louisiana· 19th of 51
$2,754
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.